

<div class="form_container" style="width: 400px;">
<form id="editMedicineForm">
	<input type="hidden" id="medicine_id" name="medicine_id" value="{$drug->get_id()}">
	
    <div>
        <span id="status_message" style="font-style: italic; color: red;"></span>
    </div>
    <table cellspacing="0" cellpadding="0">
        <tr>
            <td colspan="4" class="field" style="text-transform: uppercase">{translate}Medicine detail{/translate}</td>
        </tr>
        <!-- name -->
        <tr>
            <td class="label">{translate}Medicine name{/translate}</td>
            <td class="field" colspan="3">
            	<input type="text" id="medicine_name" name="medicine_name" value="{$drug->get('proprietary_name')}" style="width: 250px;">                
            </td>                                
        </tr>

        <tr>
            <td class="label">{translate}Generic name{/translate}</td>
            <td class="field" >
                <select name="original_name_id" style="width: 250px">
                	<option value="0" label="---">- - -</option>
                    {html_options options=$originalNameList selected=$drug->get('drug_original_name_id')}
                </select>
            </td>                                
        </tr>
        
        <tr>
            <td class="label">{translate}Usage unit{/translate}</td>
            <td class="field">
                <select name="enum_unit" style="width: 120px">
                	<option value="0" label="---">- - -</option>
                    {html_options options=$unitList selected=$drug->get('enum_unit_import_sell')}
                </select>
            </td>                                
        </tr>
        <tr>
            <td class="label">{translate}Usage{/translate}</td>
            <td class="field" >                 
                <select name="enum_usage" style="width: 120px">
                	<option value="0" label="---">- - -</option>
                    {html_options options=$defaultUsageList selected=$selectedUsage}
                </select>
            </td>                                
        </tr>
        
  		<tr>
  			<td colspan="4">
				    <div align="right" style="padding-top: 10px;">
				    	<input type="text" style="display: none;">				    					    
					    <div id="btn_save">
					    	<span id="successMessage1" style="color: green; display: none;"></span>
					    	<input type="button" id="button_save" onclick="javascript:saveMedicine();" value="{translate}Save{/translate}">	 					        					       					            					       
					    </div>
					    <div id="barLoading" style="display:none;">
					        <img src="{$base_uri}images/ajax-loader.gif"/>
					    </div>
					</div>  				
  			</td>
  		</tr>    
    </table>
</form>
</div>